Predicting prognosis for adults with depression using individual symptom data: a comparison of modelling approaches
Psychological Medicine, vol. 53, pp. 1–11
Abstract
BACKGROUND: This study aimed to develop, validate and compare the performance of models predicting post-treatment outcomes for depressed adults based on pre-treatment data. METHODS: = 918) nine models. Predictors included depressive and anxiety symptoms, social support, life events and alcohol use. Weighted sum scores were developed using coefficient weights derived from network centrality statistics (models 1-3) and factor loadings from a confirmatory factor analysis (model 4). Unweighted sum score models were tested using elastic net regularised (ENR) and ordinary least squares (OLS) regression (models 5 and 6). Individual items were then included in ENR and OLS (models 7 and 8). All models were compared to one another and to a null model (mean post-baseline Beck Depression Inventory Second Edition (BDI-II) score in the training data: model 9). Primary outcome: BDI-II scores at 3-4 months. RESULTS: Models 1-7 all outperformed the null model and model 8. Model performance was very similar across models 1-6, meaning that differential weights applied to the baseline sum scores had little impact. CONCLUSIONS: Any of the modelling techniques (models 1-7) could be used to inform prognostic predictions for depressed adults with differences in the proportions of patients reaching remission based on the predicted severity of depressive symptoms post-treatment. However, the majority of variance in prognosis remained unexplained. It may be necessary to include a broader range of biopsychosocial variables to better adjudicate between competing models, and to derive models with greater clinical utility for treatment-seeking adults with depression.
Authors 18
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Joshua E. J. Buckman corresponding
St Pancras Hospital · University College London · Camden and Islington NHS Foundation Trust
Affiliation as printed
Research Department of Clinical, Educational & Health Psychology, Centre for Outcomes Research and Effectiveness (CORE), University College London, 1-19 Torrington Place, London, UK
iCope - Camden & Islington Psychological Therapies Services - Camden & Islington NHS Foundation Trust, St Pancras Hospital, London, UK
iCope – Camden & Islington Psychological Therapies Services – Camden & Islington NHS Foundation Trust, St Pancras Hospital, London, UK
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University of California, Los Angeles
Affiliation as printed
Department of Psychiatry, University of California, Los Angeles, Los Angeles, CA, USA
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Affiliation as printed
Research Department of Clinical, Educational & Health Psychology, Centre for Outcomes Research and Effectiveness (CORE), University College London, 1-19 Torrington Place, London, UK
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Affiliation as printed
Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
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Affiliation as printed
Research Department of Clinical, Educational & Health Psychology, Centre for Outcomes Research and Effectiveness (CORE), University College London, 1-19 Torrington Place, London, UK
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Affiliation as printed
Statistical Science, University College London, 1-19 Torrington Place, London, UK
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Affiliation as printed
Department of Psychology, School of Arts and Sciences, 425 S. University Avenue, Philadelphia PA, USA
Department of Psychology, School of Arts and Sciences, 425 S. University Avenue, PhiladelphiaPA, USA
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Department of Health Sciences, University of York, Seebohm Rowntree Building, Heslington, York, UK
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Affiliation as printed
Department of Psychology, Vanderbilt University, Nashville, TN, USA
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Affiliation as printed
Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Aldermoor Health Centre, Southampton, UK
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Affiliation as printed
Department of Psychology, University of Exeter, Sir Henry Wellcome Building for Mood Disorders Research, Perry Road, Exeter, UK
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Affiliation as printed
Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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Affiliation as printed
Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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Affiliation as printed
Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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Affiliation as printed
Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, Bristol, UK
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Affiliation as printed
Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Bristol, UK
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Affiliation as printed
Division of Psychiatry, University College London, Maple House, London, UK
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St Pancras Hospital · University College London · Camden and Islington NHS Foundation Trust
Affiliation as printed
Camden & Islington NHS Foundation Trust, St Pancras Hospital, London, UK
Research Department of Clinical, Educational & Health Psychology, Centre for Outcomes Research and Effectiveness (CORE), University College London, 1-19 Torrington Place, London, UK
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